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25G Vitrectomy for the Treatment of Chronic Intermediate Uveitis with Retinal Cyst

Niloofar Piri, MD, Shlomit Schaal, MD, PhD

Shlomit Schaal, MD, PhD, and Niloofar Piri, MD, present 25G vitrectomy surgery for an intermediate chronic uveitis of unknown etiology with heavy vitreous floaters. A 62-year-old Caucasian gentleman presented with chronic uveitis and heavy vitreous floaters. Laboratory workup has not revealed the inflammation etiology. The pupil was miotic and unresponsive to topical dilation, therefore iris hooks were used to dilate the pupil. 25 G vitrectomy was performed for diagnostic and therapeutic purposes. 25G trocars were inserted in a beveled manner. 25G vitrectomy was performed. An incidental retinal cyst was identified and was surrounded by endolaser photocoagulation. Air/Fluid exchange was performed, and hooks and cannulas were removed. Patient’s vision post-op improved from 20/200 to 20/40. Vitreous sample investigation for viruses, and malignant cells was negative.

Shlomit Schaal, MD, PhD, and Niloofar Piri, MD, present 25G vitrectomy surgery for an intermediate chronic uveitis of unknown etiology with heavy vitreous floaters. A 62-year-old Caucasian gentleman presented with chronic uveitis and heavy vitreous floaters. Laboratory workup has not revealed the inflammation etiology. The pupil was miotic and unresponsive to topical dilation, therefore iris hooks were used to dilate the pupil. 25 G vitrectomy was performed for diagnostic and therapeutic purposes. 25G trocars were inserted in a beveled manner. 25G vitrectomy was performed. An incidental retinal cyst was identified and was surrounded by endolaser photocoagulation. Air/Fluid exchange was performed, and hooks and cannulas were removed. Patient’s vision post-op improved from 20/200 to 20/40. Vitreous sample investigation for viruses, and malignant cells was negative.

Shlomit S. United States - 33 months ago

Walid M. - 33 months ago

I have no comment about the surgery itself, but the persian background music was an excellent choice!

Walid M. - 33 months ago

I have no comment about the surgery itself, but the persian background music was an excellent choice!

Shlomit S. United States - 63 months ago

Thank you for this important comment. Certainly, ophthalmic cysticercosis was in the differential diagnosis in this case. It can be diagnosed by visualizing the parasite in eye by fundoscopy. In this case, we did not see a parasite during surgery nor during our post op exams (we could not see the cyst pre-op). The patient had no other symptoms, and no CNS involvement. Antibodies to cysticerci were not demonstrated in serum by EITB (Enzyme Linked Immunotransfer Blot) assay. The uveitis responded well to intra-operative injection of triamcinolone acetonide, with complete resolution. PCR was negative for bacteria, viruses, and toxoplasmosis. Cytology was negative. The cyst may be a degenerative retinal cyst, unrelated to the uveitis.

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